12-o-tetradecanoylphorbol-13-acetate in treating patients with hematologic cancer or bone marrow disorder

Conditions: Chronic Myeloproliferative Disorders; Leukemia; Lymphoma; Multiple Myeloma and Plasma Cell Neoplasm; Myelodysplastic Syndromes; Myelodysplastic/Myeloproliferative Diseases; Precancerous/Nonmalignant Condition

Summary: rationale: drugs used in chemotherapy use different ways to stop cancer cells from dividing so they stop growing or die. purpose: this phase i trial is studying the side effects and best dose of 12-o-tetradecanoylphorbol-13-acetate in treating patients with hematologic cancer or bone marrow disorder that has not responded to previous treatment.

objectives: * determine the maximum tolerated dose and dose limiting toxicity of 12-o-tetradecanoylphorbol-13-acetate (tpa) in patients with relapsed or refractory hematologic malignancies or bone marrow disorders. * determine the pharmacokinetics of tpa in these patients. * determine the effects of tpa on the cellular composition of blood and bone marrow in these patients. outline: this is a dose-escalation study. patients receive 12-o-tetradecanoylphorbol-13-acetate (tpa) iv over 1 hour on days 1 and 8 followed by 2 weeks of rest. courses repeat in the absence of disease progression or unacceptable toxicity. cohorts of 3-6 patients receive escalating doses of tpa until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose at which no more than 1 of 6 patients experiences dose limiting toxicity. projected accrual: approximately 36 patients will be accrued for this study.

Eligibility criteria:
disease characteristics: * histologically proven relapsed or refractory hematologic malignancy or bone marrow disorder for which there is no standard curative therapy, including, but not limited to: * myelodysplasia * multiple myeloma * myeloproliferative syndrome * chronic lymphocytic leukemia * aplastic anemia * non-hodgkin's lymphoma * acute leukemia * hodgkin's lymphoma * chronic myelogenous leukemia patient characteristics: age: * over 18 performance status: * ecog 0-2 life expectancy: * greater than 1 month hematopoietic: * not specified hepatic: * bilirubin no greater than 1.5 times upper limit of normal (uln) * ast no greater than 3 times uln renal: * creatinine no greater than 2.0 mg/dl cardiovascular: * cardiac ejection fraction greater than 40% pulmonary: * fev_1 greater than 50% predicted other: * no active infection * not pregnant or nursing * negative pregnancy test * fertile patients must use effective contraception during and for 10 weeks after study participation * no uncontrolled psychiatric or medical illness prior concurrent therapy: biologic therapy: * greater than 3 weeks since prior biologic therapy chemotherapy: * greater than 3 weeks since prior chemotherapy and recovered endocrine therapy: * not specified radiotherapy: * not specified surgery: * not specified other: * no other concurrent investigational agents

Keywords: monoclonal gammopathy of undetermined significance recurrent adult hodgkin lymphoma recurrent cutaneous t-cell non-hodgkin lymphoma isolated plasmacytoma of bone extramedullary plasmacytoma refractory multiple myeloma waldenstrom macroglobulinemia recurrent adult acute myeloid leukemia recurrent adult acute lymphoblastic leukemia relapsing chronic myelogenous leukemia refractory chronic lymphocytic leukemia polycythemia vera chronic idiopathic myelofibrosis essential thrombocythemia refractory hairy cell leukemia refractory anemia refractory anemia with ringed sideroblasts refractory anemia with excess blasts refractory anemia with excess blasts in transformation chronic myelomonocytic leukemia t-cell large granular lymphocyte leukemia acute undifferentiated leukemia recurrent grade 1 follicular lymphoma recurrent grade 2 follicular lymphoma recurrent grade 3 follicular lymphoma recurrent adult diffuse small cleaved cell lymphoma recurrent adult diffuse mixed cell lymphoma recurrent adult diffuse large cell lymphoma recurrent adult immunoblastic large cell lymphoma recurrent adult lymphoblastic lymphoma recurrent adult burkitt lymphoma recurrent adult t-cell leukemia/lymphoma secondary acute myeloid leukemia previously treated myelodysplastic syndromes secondary myelodysplastic syndromes primary central nervous system lymphoma prolymphocytic leukemia primary systemic amyloidosis recurrent mantle cell lymphoma angioimmunoblastic t-cell lymphoma anaplastic large cell lymphoma refractory cytopenia with multilineage dysplasia recurrent mycosis fungoides/sezary syndrome chronic eosinophilic leukemia chronic neutrophilic leukemia atypical chronic myeloid leukemia myelodysplastic/myeloproliferative disease, unclassifiable adult acute myeloid leukemia with t(8;21)(q22;q22) adult acute myeloid leukemia with t(16;16)(p13;q22) adult acute myeloid leukemia with inv(16)(p13;q22) adult acute myeloid leukemia with 11q23 (mll) abnormalities adult acute myeloid leukemia with t(15;17)(q22;q12)